USMLE Step 2, Eligibility, Syllabus, Exam Pattern

he USMLE Step 2 examination is the second step of the USMLE examination. It is the second step among the three-step examination of the USMLE, mandatory for U.S. medical licensure in 2025.
authorImageVaishnavi k Pandhari4 Aug, 2025
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USMLE Step 2

USMLE Step 2 CK is a licensure exam that assesses medical students' knowledge, skills, and understanding of clinical science in patient care under supervision. Focusing on health promotion and disease prevention, Step 2 CK ensures that future physicians do not lose sight of clinical science principles and fundamental patient-centered skills, which underpin practicing medicine safely and competently under supervision. 

Step 2 CK assesses the examinee's ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. This gives due prominence to clinical sciences and basic patient-centered skills, the foundation of the safe and competent practice of medicine under supervision.

USMLE 

The USMLE, or the United States Medical Licensing Examination, simply refers to the examination required to gain a medical license within the US. The USMLE, sponsored by two non-profit organizations Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), was designed to provide a single national examination to be used by all state medical boards for the medical licensure of allopathic physicians. United States Medical Licensing Examination: USMLE Test is a sequential US medical licensing exam for licensing of the medical graduate who wants to practice unsupervised medicine in the USA. It has three levels of examination, namely:

  • USMLE Step 1

  • USMLE Step 2 CK and Step 2 CS

  • USMLE Step 3

The United States Medical Licensing Examination (USMLE) Step 2 is a crucial examination for medical students and graduates who aspire to practice medicine in the United States. Traditionally, it is divided between Step 2 Clinical Knowledge (CK) and Step 2 Clinical Skills (CS). The Step 2 CS examination has been discontinued. Thus, when people refer to USMLE Step 2, they principally mean the USMLE Step 2 Clinical Knowledge (CK) examination.

 This exam tests the candidates for the ability to apply medical knowledge, skills, and understanding of clinical science essential for patient care under supervision. Think of it as showing that you can use what you learned in medical school to help real patients, identify diseases, and decide on treatments. Getting through this exam is one of the big steps on the way to becoming a licensed doctor in the U.S.

 

UMSLE Step 2 Exam Overview

Feature

Details

Exam Name

USMLE Step 2 Clinical Knowledge (CK)

Purpose

To assess your ability to apply medical knowledge and understanding of clinical science important for patient care under supervision.

Governing Bodies

Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME)

Exam Format

Computer-based test, multiple-choice questions

Total Duration

Approximately 9 hours (including 8 hours of testing, 45 minutes of break time, and a 15-minute tutorial)

Number of Blocks

8 blocks

Questions per Block

Each block has up to 40 questions. The total questions is around 318.

Testing Window

Year-round (Candidates choose an eligibility period)

Result Release

Typically 3-4 weeks (but can take longer for exams taken in late June through July)

Official Website

www.usmle.org

 

USMLE Step 2 Exam 2025 Exam Date

Unlike many other exams, the USMLE Step 2 CK does not have fixed "exam dates" for the entire year. Instead, candidates choose a three-month eligibility period during which they plan to take the exam. For example, if you choose an "April-May-June" eligibility period, you can take the exam any day during those three months, dependent on test centre availability.

Exam 2025 Eligibility 

To be eligible for the USMLE Step 2 CK exam, you generally need to be in one of these categories: 

  • A medical student currently enrolled in, or a graduate of, a medical school in the U.S. or Canada that is accredited by the Liaison Committee on Medical Education (LCME). 

  • A medical student currently enrolled in, or a graduate of, a medical school outside the U.S. and Canada that is listed in the World Directory of Medical Schools and meets ECFMG eligibility criteria. These are typically international medical graduates (IMGs). 

  • In addition, you have to meet some additional requirements of the USMLE program and the National Board of Medical Examiners (NBME) or Educational Commission for Foreign Medical Graduates (ECFMG). Therefore, it is very important to keep checking the official USMLE website for the latest and most precisely defined eligibility requirements.

USMLE Step 2 Exam Syllabus

The USMLE Step 2 Syllabus test consists of a huge range of various clinical science subjects. It evaluates knowledge about important and common diseases or how to diagnose them and manage patients. All questions would test the capability of applying knowledge rather than recalling facts. The USMLE Step 2 book will give you detailed information about the syllabus.

The main divisions of the syllabus include:

  • Internal Medicine: The widest section covering diseases of the heart, lungs, kidneys, stomach, blood, a few, and much more.

  • Pediatrics: Diseases and health problems in children.

  • Obstetrics and Gynecology (OB/GYN): Women's health, pregnancy, and childbirth.

  • Psychiatry: All mental health conditions.

  • Surgery: Conditions related to surgery and procedures that involve surgery.

  • And other areas: Emergency medicine, ethics, patient safety, and population health.

  • The focus on the exam will be regarding organ systems (i.e., cardiovascular system) and common medical tasks (i.e., diagnosis, prognosis, or management).

 

USMLE Step 2 2025 Exam Pattern

The USMLE Step 2 CK examination is a computer-based exam. The pattern is as follows:

  • USMLE Step 2 questions: All questions are multiple-choice. In most cases, they pose a patient story ("vignette") and then ask to choose the best option among the provided options.

  • Number of Blocks: There are a total of 8 blocks under this exam.

  • Questions per Block: Each block shall contain as many as 40 questions. The actual number of questions may vary slightly, but the total number of questions across the entire examination will be around 318.

  • Time allocated per Block: Each block has a time limit of 1 hour (60 minutes).

  • Total Exam Period: The entire testing session would take about 9 hours, including the tutorial and breaks.

  • Emphasis in the USMLE Step 2 exam is given under the supervision of patient care. It tests how much knowledge the candidate has regarding clinical science and its application during patient care and disease prevention.

  • In Step 2 CS, the candidate interacts with a standardized patient, makes a diagnosis, and treats the patient. A standardized patient is trained to behave like a real patient.

  • Step 2 CS: The candidate answers 12 patients, listens to them, communicates with them, diagnoses them, and treats them. Each patient spends 15 minutes with the candidate.

 

Type

Components

Details

Computer-based

Question Type

All questions are multiple-choice, often presenting a patient story (vignette)

Computer-based

Number of Blocks

8 blocks

Computer-based

Questions per Block

Up to 40 questions (total around 318)

Computer-based

Time per Block

1 hour (60 minutes)

Computer-based

Total Exam Time

About 9 hours (including tutorial and breaks)

Patient interaction

Number of Patients

12 patients

Patient interaction

Time per Patient

15 minutes

Patient interaction

Assessment

Diagnosis and treatment of standardized patients

 

Application Form for USMLE Step 2 Exam 2025

USMLE Step 2 registration application differs by whether you are a U.S. or Canadian medical student or graduate, or an international medical graduate or international medical student.

  • U.S./Canadian Medical Students/Graduates: Application is through the NBME.

  • International Medical Graduate/Student (IMG): Application through the ECFMG. 

  • An application form will ask questions about personal information, medical school details, and eligibility period. You will also need to submit official documents like transcripts, on record with your medical school. Always ensure to fill out the form properly and that all the mentioned information is accurate. 

Online Application for USMLE Step 2 Exam 2025

To appear for the USMLE Step 2 CK examination, visit the following official sites: 

  • For U.S./Canadian Medical Students/Graduates: The NBME website (www.nbme.org) is the source of the "USMLE" section.

  • For International Medical Students/Graduates (IMGs): The ECFMG site (www.ecfmg.org) includes the "USMLE" section. 

 

USMLE Step 2 Application Fees 2025

The application fee for the USMLE Step 2 CK exam may vary slightly depending on location and year. For applicants in 2025, the amount will fall between $990 and $1000 USD, with the much precise portion being attached to international medical graduates. Fees may slightly vary for U.S. and Canadian medical students. 

 Apart from the exam fee, you might incur small charges depending on your particular requirements (rescheduling fees or fees for extending your eligibility period). It is always advisable to check the official NBME or ECFMG website for the most accurate and up-to-date fee information.

 

Fee Type

Step 2 CK

Application Fees

$910

Extension of Eligibility Period

$70

Testing Region Change

$65

Rescheduling Fees

$0-$1285

Score Recheck

$80

Paper transcript

$70/request (up to 10 transcripts)

USMLE Transcript: ERAS(Electronic Transmission)

$80 per ERAS



USMLE Step 2 Exam 2025 Results 

After you take the USMLE Step 2 CK exam, generally, the results are released in about 3 to 4 weeks. However, this period could be longer, especially for tests taken late June to July, because of the annual modification of test items. USMLE Step 2 schedule is as on the results of the USMLE Step 1 examination. 

USMLE Step 2 CS results are declared as Pass / Fail. There are no USMLE Scores for USMLE Step 2 CS. USMLE Step 2 CK, just as Step 1 is scored in 3 digits. There is no minimum qualifying figure set for the candidates, but the latest qualifying scores for USMLE Step 2 CK are 209.

The score report will show numerically scored results and pass/fail status. A passing score is required to move forward in your medical career journey in the U.S. You will also be notified through email once your score report becomes available. You can then access it securely online through the NBME or ECFMG website where you applied.

 

The site's official page posts all facts about the USMLE results. The results of the USMLE tests were published on the official website USMLE, where each student schedules for his or her respective step, and students receive emails notifying them as soon as their scores are released. Candidates can retrieve the report on the official USMLE website for over a year before it is removed. 

 

 

USMLE STEM 2 FAQs

Is the USMLE Step 2 Clinical Skills exam even required?

No, the USMLE Step 2 Clinical Skills (CS) examination has been cancelled; only the Step 2 Clinical Knowledge (CK) is required.

How long does the USMLE Step 2 CK last?

The entire duration of the examination is approximately 9 hours, within which there is 8 hours of testing time, along with a tutorial and break period.

Just how important is USMLE Step 2 CK to residency?

Step 2 CK scores are really important for residency applications since they demonstrate your clinical knowledge and ability to apply it.

What is a good USMLE Step 2 CK score?

While a passing score is sufficient, a score above 240 is generally considered very good and competitive for many residency programs.
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